The effect of antioxidants on Helicobacter pylori eradication: A systematic review with meta-analysis
The effect of antioxidants on Helicobacter pylori eradication: A systematic review with meta-analysis
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抗氧化剂对根除幽门螺杆菌的影响：荟萃分析的系统评价
DOI：
10.1111/hel.12535
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发表时间：
2018
期刊：
影响因子：
4.4
通讯作者：
Lu Nong-Hua
中科院分区：
文献类型：
--
作者：
Yang-Ou Yao-Bin;Hu Yi;Zhu Yin;Lu Nong-Hua
背景：在三联或四联治疗中加入抗氧化剂的有效性和安全性尚不清楚。材料和方法本系统综述按照PRISMA 2009指南进行。系统检索PubMed、EMBASE和Cochrane Library数据库，使用以下关键词识别可能相关的出版物：[幽门螺杆菌]或[幽门螺杆菌]。幽门螺杆菌或Hp)和（抗氧化剂）或（维生素）或（N‐乙酰半胱氨酸）或（姜黄素）或（蔓越莓）)。本研究的主要目的是根据ITT和PP分析来评估在三联或四联治疗中添加抗氧化剂的疗效。第二个终点是副作用和h的比较疗效。根据不同的抗氧化剂和抗生素组合来清除幽门螺杆菌。结果纳入9项研究，1260名受试者。总根除率。根据ITT（合并RR [95% CI] = 1.17[0.99‐1.38]；P=0.07）和PP（合并RR [95% CI] = 1.15[0.99‐1.34；P=0.07）分析，根除治疗联合抗氧化剂组幽门螺杆菌感染不优于未使用抗氧化剂组。两组之间的副作用没有差异（合并RR [95% CI]， 1.36[0.81‐2.28]；P=0.24）。然而，与不补充维生素的根除方案相比，补充维生素（1400 mg/d）的根除效果显著优于不补充维生素的根除方案（合并RR [95% CI] = 1.57 [1.35, 1.84]；P<0.01）。特别是，在以阿莫西林-克拉霉素为基础的亚组中，粗h。ITT分析显示，加抗氧化剂和不加抗氧化剂根除治疗的幽门螺杆菌根除率分别为81.3%和68.6%，差异有统计学意义（合并RR [95% CI] = 1.23[1.02‐1.49]；P=0.03）。结论在阿莫西林-克拉霉素治疗中添加抗氧化剂（维生素、N -乙酰半胱氨酸、姜黄素、蔓越莓）可提高该病的根除率，且在大剂量补充维生素时可能有效。然而，抗氧化剂补充剂对改善副作用没有影响。
BackgroundThe efficacy and safety of the addition of antioxidants to triple or quadruple therapy were unclear.Materials and MethodsThis systematic review was performed in accordance with the PRISMA 2009 guidelines. A systematic search of PubMed, EMBASE, and the Cochrane Library databases was conducted to identify potentially relevant publications using the following keywords: ([Helicobacter pylori] or [H. pylori] or [Hp]) and ([antioxidant] or [vitamin] or [N‐acetylcysteine] or [curcumin] or [cranberry]). The primary end‐point of this study was to evaluate the efficacy of the addition of antioxidants to triple or quadruple therapy according to ITT and PP analysis. The second end‐points were side effects and the comparative efficacy in terms ofH. pylorieradication according to different antioxidant and antibiotic combinations.ResultsWe included 9 studies with 1260 participants. The total eradication rate ofH. pyloriin the group combining eradication therapy with antioxidants was not superior to that without antioxidants according to the ITT (pooled RR [95% CI] = 1.17 [0.99‐1.38];P=0.07) and PP analysis (pooled RR [95% CI] = 1.15 [0.99‐1.34;P=0.07]. There were no differences regarding side effects between the two groups (pooled RR [95% CI], 1.36 [0.81‐2.28];P=0.24). However, the eradication regimen with vitamin supplementation (1400 mg/day) showed a significant, superior efficacy in eradication relative to those without supplementation (pooled RR [95% CI] = 1.57 [1.35, 1.84];P<0.01). In particular, in the amoxicillin‐clarithromycin‐based subgroup, the crudeH. pylorieradication rate determined by ITT analysis was 81.3% and 68.6% for eradication therapy with and without antioxidant supplementation, respectively, which was a statistically significant difference (pooled RR [95% CI] = 1.23 [1.02‐1.49];P=0.03).ConclusionsThe addition of antioxidants (vitamin, N‐acetylcysteine, curcumin, cranberry) to amoxicillin‐clarithromycin‐based therapy could improve the eradication rate, and vitamin supplementation might be effective at a high dosage. However, antioxidant supplements have no impact on improving side effects.